State’s troubled vaccine bargain with Blue Shield

It would not have been fair to expect Gov. Gavin Newsom’s response to the coronavirus to be neat and orderly.

After all, we’re in the middle of a pandemic. We haven’t been through this before. There is no simple playbook, especially for a state as large and complex as California. The governor and state officials have had to figure it out as they go along. Such is the nature of an unprecedented crisis.

To a certain extent, that helps explain the confusion over the state’s testing, the bungled attempt at contact tracing, the constantly changing criteria for sheltering and reopening businesses, and the botched effort to reopen schools.

But, as we enter the second year of the pandemic, Californians have reason to be frustrated by the continuing confusion, especially the chaotic rollout of vaccine distribution. This is the one Newsom had time to prepare for.

Instead, residents face shifting criteria and a fractured system that has left them to fend for themselves as they toggle between websites for national drugstore chains, county health departments, the state registry and sign-up lists with health care providers such as Kaiser and local hospital systems.

Newsom’s attempt to bring order to the chaos with a centralized system is laudable. But to try to do so by unilaterally making Blue Shield the vaccine czar was tone deaf and ill-advised.

Had the company been selected and prepared to step up in December, we’d be having a different conversation. But the governor has left counties to fend for themselves for three months. They’ve worked out systems to distribute vaccine and often best know how to get them first into the arms of the most vulnerable. It hasn’t been perfect. Far from it.

Contrary to Newsom’s claims in his State of the State address on Tuesday, the state does not have “the most robust vaccination program in the country.” On a per-capita basis, California ranks 46th of 50 states for the number of residents fully vaccinated.

But to rip up the system now and start from scratch — by appointing Blue Shield to create, manage and oversee a statewide network of vaccine providers — makes no sense. Which is why the counties revolted and forced the state to reconsider.

County officials don’t want to be told this late in the game how to do what they were already doing. Some, including officials in Santa Clara and Contra Costa counties, have also raised legitimate concerns about the financial conflict Blue Shield might have as it makes decisions on the state’s behalf about which health care providers receive vaccines.

That potential conflict, which could run afoul of the state’s most serious law aimed at preventing selfdealing, remains an issue even as the counties opt out of the Blue Shield network. All indications are that Blue Shield will continue to play a key role with distributing vaccines to non-county entities.

Blue Shield has been a major donor to Newsom’s campaign, his ballot committees and his program to address homelessness. The company’s no-bid contract to oversee vaccine distribution prohibits it from directly profiting on the deal. But the decisions it makes could potentially affect the people it insures and the health care providers it does business with.

In an ideal world, the state would handle the distribution itself. But the California bureaucracy, which has brought us the debacles at, for example, the Department of Motor Vehicles and the Employment Development Department, is probably not up to the vaccine distribution assignment.

So, Blue Shield, or another insurer, might be the best alternative the state has to provide the service. But the conflict concerns should be independently evaluated before the company fully takes the reins, even in a more limited capacity, at the end of the month.

We don’t expect Newsom’s response to the pandemic to be perfect, or even close. But the longer it goes on, the better he needs to become at anticipating problems and addressing them thoughtfully, legally and transparently.